New Study Challenges
Friday, July 20, 2018
Latest Statin Guidelines
Statin drugs are the cholesterol-lowering darlings of contemporary medicine. So much so that fully half of men age 65-74 are prescribed them and one in four adults – both men and women – over 45 are taking them.
An increasing proportion of these patients don’t have the established cardiovascular disease for which statins were initially approved by the FDA. Indeed, despite unrelenting controversy over their widespread use and reported side effects, the latest statin guidelines expand their recommended use to another 13 million Americans – in many cases based solely on their age.
The statin controversy resurfaced anew with last week’s publication of statin study results suggesting that statin users are failing to follow a lower-fat diet, as suggested with their use. Indeed, this study found they’re actually consuming even more calories and fats than they did before being prescribed their statin drugs.
It isn’t clear how much of this is a direct result of the statins themselves and how much is due to patients slacking off because they feel immunized by virtue of the promised protections of their statin regimen.
Equally troubling as the 10% increase in calorie consumption that pushed the average weight of statin users studied from overweight into obesity was their over 30% higher rate of type 2 diabetes.
If there is any cardiac protection provided by statins in the abstract, their benefits in actual practice would seem to be greatly offset by these adverse consequences. Obesity and type 2 diabetes not only contribute to cardiovascular disease, but to strokes and virtually all forms of cancer, among other disease complications.
These healthcare trade-offs are seldom disclosed to patients, as I discuss in detail in Our Healthcare Sucks.
Doubts About Statins for Prevention
Prescribing statins for those at risk for cardiovascular disease but with no history of it is called “primary prevention”, meaning the prevention of a first cardiovascular event. And here the evidence is less than compelling that these drugs provide any real benefit (Review Raises Questions About Statins for Primary Prevention).
This Cochrane Review raised troubling questions about the evidence base supporting the use of statins for primary prevention.
According to the report on this review at cardiobrief.org:
“The authors found ‘evidence of selective reporting of outcomes, failure to report adverse events and inclusion of people with cardiovascular disease.’ They concluded that ‘only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk.’”
But there’s more to worry about than lack of benefit. Side effects include muscle pain, memory loss, and several other troubling side effects in addition to the longer-term complications like obesity and type 2 diabetes discussed above.
Watch this video from ABC News for more on these unwanted effects: